Cole Barkley I plan to retain Cole as a client. Cole exhibits substance abuse behaviors that threaten to worsen is he does not receive effective treatment in a timely manner. Further, Cole denies that his substance abuse is detrimental and downplays it as just having fun with friends. His substance abuse includes drinking to the point of drunkenness, smoking marijuana, and taking various prescription drugs. Cole's substance abuse issues have been recognized for about a year and they reached a crux this school year when Cole was expelled from school for smoking marijuana on the campus grounds.

Cole and his sister are being raised by his grandmother as both of parents died when they were very young. Cole may have issues of abandonment, such that termination of a counseling relationship that has barely gotten underway may exacerbate those feelings in Cole. The therapeutic goals developed for Cole have not been met and it is crucial that therapy not end until Cole can point to specific, positive behavioral changes in his life that have resulted from his efforts in the counseling sessions. For the past three weeks, Cole has been attending a two sessions a week at a teen counseling center. The goal of the sessions is to determine the causes of his behavior. Although Cole has not opened up to the teen center counselor or other teens in the program -- or to me in his counseling sessions -- his attendance at school is improving. Cole's attitude, however, has not perceptibly changed.

Given the short duration of treatment compared to the seriousness of Cole's substance abuse, and the important juncture at which Cole finds himself -- following expulsion from his freshman year of high school -- continuation of his one-on-one counseling sessions is warranted. The importance of a stable counseling relationship as Cole comes to grip with the serious nature of the decisions he has made and the underlying, unresolved drivers of his behavior, Cole needs to be able to count on a relationship with a skilled adult who can help him navigate these road bumps and develop a workable plan for engaging in school and life without dependence on controlled substances.

James Hova

I plan to retain James Hova as a client. At age nine, James...

He is being raised by his mother. James' parents are divorced and his father visits him on occasional weekends. James is disruptive in class and his attention-getting behavior may be functioning as a distraction from his poor academic performance. The adults who oversee James academic program and his homework sessions report that he is easily frustrated by schoolwork and other demanding activities. In his second year of elementary school, the disruptive behavior appears to have escalated and James rejects anything that requires academic effort.
James is participating in an after school basketball program which he enjoys and in which he is experiencing success. The after school sports program does offer a way for James to get more attention and to release some of the pent up energy he experiences, partly just because he is a nine-year-old boy and partly because he bottles up some of the frustration he feels due to his lack of success in school. He is also receiving tutoring in his schoolwork at a community center after school. The tutoring has not helped James to focus on his academic work, nor is it associated with any diminishment of his problem behavior.

James has been expressive in his counseling sessions with me and has articulated that he hates schools, just wants to hang out with friends, and always has to do things he doesn't want to do. In addition, James has expressed frustration that his mother does not understand him or his problems, and that his father is never around. James appears to be suffering from low self-esteem and his acting out behavior is a culturally accepted way to gain attention and feel more in control of his life situation.

A key need for James overall treatment plan is to determine if any learning difficulties or mental health issues are present. Because James' academic performance has steadily fallen further…